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García E, Ares-Lavalle G, Borelli M, Fernández MA, Agrest M, Ardila-Gómez S. [Attitudes of neighbors about the treatment and community life of people with severe mental health disorders in Argentina]. CAD SAUDE PUBLICA 2023; 39:e00083123. [PMID: 37851727 PMCID: PMC10581681 DOI: 10.1590/0102-311xes083123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/28/2023] [Accepted: 08/23/2023] [Indexed: 10/20/2023] Open
Abstract
A psychiatric reform is underway in Latin America and the Caribbean. Specifically in Argentina, a model of community mental health is being built, and prolonged psychiatric hospitalizations are still taking place, especially in neuropsychiatric hospitals. Therefore, it is necessary to closely monitor the psychiatric reform. One of the possible ways to monitor the reform is by analyzing society's attitudes towards prolonged psychiatric hospitalization as a mean of mental health treatment. Thus, an analytical observational study was conducted at the Buenos Aires Province, Argentina, in 2021, to analyze the behavior of neighbors of people who had prolonged psychiatric hospitalizations and who received housing support. Questionnaires were applied to neighbors and non-neighbors, addressing the behaviors toward prolonged psychiatric hospitalization as a mean of treatment, social distance toward people who were hospitalized, as well as specific interviews with key informants from neighborhoods where people with severe mental health disorders and who receive housing support live. Based on the answers of neighbors and non-neighbors, no statistically significant differences were identified in behaviors toward prolonged psychiatric hospitalization as a mean of treatment, nor for social distance in relation to people who were hospitalized. Key informants conditioned their assessment of prolonged hospitalization and valued the role of support teams in making community life viable.
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Affiliation(s)
- Elena García
- Centro de Salud Mental Comunitaria E. Pichón Riviere, La Plata, Argentina
| | | | - Mariana Borelli
- Hospital José A. Estéves, Ministerio de Salud, Temperley, Argentina
| | - Marina A Fernández
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Martín Agrest
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina
- Proyecto Suma, Buenos Aires, Argentina
| | - Sara Ardila-Gómez
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
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Borelli M, García E, Moyano J, Saralegui L, Murlender L, Ares Lavalle G, Arzuaga MM, Oliveira AC, Fernández MA, Ardila-Gómez SE. [Housing support after long-term psychiatric hospitalization: Resources and strategies in three experiences in Buenos Aires Province, Argentina]. Vertex 2022; 33:5-15. [PMID: 35856778 DOI: 10.53680/vertex.v33i156.174] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Housing is one of the main supports needed to guarantee community life of people who had long-term psychiatric hospitalizations. In Argentina, housing support experiences have been developed for decades, although their systematization is scarce. The objective of this paper is to describe three housing support experiences developed in the province of Buenos Aires, Argentina, which have continuity over time for more than 20 years. MATERIALS AND METHODS Document analysis and interviews with workers from the three experiences were carried out, as part of a broader project on community life and neighborhood relations of people discharged after long-term psychiatric hospitalizations. The material was analyzed qualitatively, using a time dimension and a structure and functioning one which included financing, technical resources, housing devices and support provided. RESULTS Although the types of support provided are somehow similar between the three experiences, heterogeneity in structure and functioning is observed. DISCUSSION AND CONCLUSIONS Despite the fact that the human rights framework proposes the provision of flexible and adequate support according to the needs of people, it is worth reflection on whether the reduced systematization of experiences such as those presented is due to the difficulties of the heterogeneity mentioned, or is due to a scarce evaluation culture that obstacles the learning from those experiences.
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Affiliation(s)
- Mariana Borelli
- Programa de Rehabilitación y Externación Asistida, Hospital Interzonal "José A. Estéves", Temperley, Argentina
| | - Elena García
- Centro de Salud Mental Comunitaria "Dr. Franco Basaglia"
- Hospital Interzonal Especializado de Agudos y Crónicos "Dr. A. Korn", La Plata, Argentina
| | - Jorge Moyano
- Unidad de diagnóstico y tratamiento Hospital de Día, Servicio Salud Mental, Hospital Interzonal General de Agudos "Dr. José Penna", Bahía Blanca, Argentina
| | - Lucía Saralegui
- Instituto de Investigaciones, Facultad de Psicología. Universidad de Buenos Aires, Argentina
| | - Liz Murlender
- Instituto de Investigaciones, Facultad de Psicología. Universidad de Buenos Aires, Argentina
| | - Guadalupe Ares Lavalle
- Instituto de Investigaciones, Facultad de Psicología. Universidad de Buenos Aires, Argentina
| | - María Marcela Arzuaga
- Departamento de Ciencias de la Salud, Universidad Nacional del Sur, Bahía Blanca, Argentina
| | - Ana Claudia Oliveira
- Instituto de Investigaciones, Facultad de Psicología. Universidad de Buenos Aires, Argentina
| | - Marina A Fernández
- Instituto de Investigaciones, Facultad de Psicología. Universidad de Buenos Aires, Argentina
| | - Sara E Ardila-Gómez
- Instituto de Investigaciones, Facultad de Psicología. Universidad de Buenos Aires, Argentina
- E-mail:
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Lorey M, Borelli M, Äikäs L, Youssef A, Hermansson M, Kemppainen A, Ruhanen H, Ruuth M, Matikainen S, Kovanen P, Käkelä R, Boffa M, Koschinsky M, Öörni K. Lp(a) induces inflammasome activation in human macrophages. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Affiliation(s)
- T. Kolobow
- National Heart, Lung and Blood Institute Laboratory of Technical Development Bethesda, Maryland 20892
| | - L. Gattinoni
- Institute of Anaesthesia and Intensive Care University of Milan - Milano Italy
| | - A. Pesenti
- Institute of Anaesthesia and Intensive Care University of Milan - Milano Italy
| | - M. Solca
- Institute of Anaesthesia and Intensive Care University of Milan - Milano Italy
| | - R. Fumagall
- Institute of Anaesthesia and Intensive Care University of Milan - Milano Italy
| | | | - D. Mascheroni
- Institute of Anaesthesia and Intensive Care University of Milan - Milano Italy
| | - P. Prato
- Institute of Anaesthesia and Intensive Care University of Milan - Milano Italy
| | - M. Borelli
- National Heart, Lung and Blood Institute Laboratory of Technical Development Bethesda, Maryland 20892
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Fumagalli R, Bombino M, Borelli M, Rossi F, Colombo V, Osculati G, Ferrazzi P, Pesenti A, Gattinoni L. Percutaneous Bridge to Heart Transplantation by Venoarterial ECMO and Transaortic Left Ventricular Venting. Int J Artif Organs 2018; 27:410-3. [PMID: 15202819 DOI: 10.1177/039139880402700510] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report a case in which life support for cardiogenic shock was achieved by a nonpulsatile venoarterial bypass, and left ventricular decompression was obtained by a catheter placed percutaneously through the aortic valve into the left ventricle. The blood drained from the left ventricle was pumped into the femoral artery. The normalization of left heart filling pressures allowed the resolution of pulmonary edema, and the patient underwent a successful heart transplantation following 7 days of mechanical cardiocirculatory support.
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Affiliation(s)
- R Fumagalli
- Department of Anesthesia and Critical Care, Ospedale S. Gerardo Monza, Monza, Università degli Studi Milano-Bicocca, Italy.
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Ardila-Gómez S, Ares-Lavalle G, Fernández M, Hartfiel MI, Borelli M, Canales V, Stolkiner A. Social perceptions about community life with people with mental illness: study of a discharge program in Buenos Aires province, Argentina. Community Ment Health J 2015; 51:103-10. [PMID: 24965092 DOI: 10.1007/s10597-014-9753-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 06/18/2014] [Indexed: 11/25/2022]
Abstract
Effects of living near people with mental illness in community settings have been researched as part of psychiatric reform evaluation. However, these studies have been carried out mostly in industrialized countries, where social contexts differ from those in which psychiatric reform is now being implemented. To analyze the effects of community life with people with mental illness in the neighborhoods in which they live, in Buenos Aires, Argentina. A questionnaire was administered to randomly-selected neighbors of group homes of a discharge program and an equivalent control area (n = 236). Data was analyzed both quantitatively and qualitatively. Significant differences were found between being a neighbor and having a high degree of acceptance toward people with mental illness. In addition, significant associations were found between neighbors having a high-perceived social cohesion and having a high level of acceptance toward the mentally ill. Living near people with mental illness is associated with better acceptance toward them; these results are congruent with those results found in other cultural contexts.
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Affiliation(s)
- Sara Ardila-Gómez
- Scientific and Technical Research National Council of Argentina (CONICET), Buenos Aires, Argentina,
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Granato A, Ilbeh SM, Trovò F, Borelli M, Granello G, Semenic M, Monti F, Pizzolato G. Transcranial magnetic stimulation as a new approach in medication overuse headache: a pilot study. J Headache Pain 2013. [PMCID: PMC3620142 DOI: 10.1186/1129-2377-14-s1-p168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Granato A, Ilbeh S, Trovò F, Borelli M, Granello G, Semenic M, Monti F, Pizzolato G. Transcranial magnetic stimulation as a new approach in medication overuse headache: a pilot study. J Headache Pain 2013. [DOI: 10.1186/1129-2377-1-s1-p168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Luzzati R, Confalonieri M, Cazzadori A, Della Loggia P, Cifaldi R, Fabris C, Biolo M, Borelli M, Longo C, Concia E. Prolonged hospitalisation for immigrants and high risk patients with positive smear pulmonary tuberculosis. Monaldi Arch Chest Dis 2011; 75:141-5. [PMID: 21932701 DOI: 10.4081/monaldi.2011.229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Tuberculosis (TB) occurring in immigrants and resistance to drugs are major problems for TB control in Western countries. Directly observed therapy (DOT) reduces disease transmission, but this approach may have poor results among illegal immigrants. Our aim was to evaluate a prolonged hospitalisation programme to improve early outcome of TB treatment in high risk patients. METHODS All the consecutive adult patients with sputum smear-positive pulmonary TB admitted to 2 Italian referral TB Centres were evaluated. Hospital-based DOT was provided to high risk patients up-to smear conversion. Demographic, microbiological and clinical conditions, as potential factors associated with confirmed smear conversion at 60 and 90 days of anti-tuberculous therapy were evaluated. RESULTS 122 patients were studied, 45.9% of them were immigrants (20% illegal) from high-prevalence TB countries. HIV testing was negative in all cases. Twelve patients had M. tuberculosis resistant to > or = 1 first-line anti-tuberculous agents. The rate of defaulting from TB treatment was 73%. Sputum smear became negative in 84.4% cases after 60 days and 933% cases after 90 days. At such time, smear conversion rates were similar among different high risk subgroups such as illegal immigrants (95.9%), legal foreign-born (92.5%) and Italian persons (94.8%). Persistent sputum smear positivity was independently correlated with the extent of pulmonary lesions at 60 (p < 0.0001) and 90 days (p = 0.038) of hospital-based DOT. CONCLUSIONS These findings suggest that prolonged hospitalisation for illegal immigrants and high risk TB patients, may positively influence the early outcome of TB treatment despite of drug resistance and legal status.
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Affiliation(s)
- R Luzzati
- Infectious Diseases Unit, University Hospital, Trieste, Italy
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Iemoli E, Piconi S, Fusi A, Borgonovo L, Borelli M, Trabattoni D. Immunological effects of omalizumab in chronic urticaria: a case report. J Investig Allergol Clin Immunol 2010; 20:252-254. [PMID: 20635791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
We describe a case of chronic idiopathic urticaria in which symptoms improved dramatically after treatment with omalizumab. This drug, which is approved for the treatment of asthma, has been studied in other allergic conditions and a number of reports have described its efficacy as an immunomodulator in chronic and physical urticaria. Immunopathologic mechanisms are poorly understood. In chronic autoimmune urticaria, it has been postulated that this monoclonal antibody against immunoglobulin (Ig) E might reduce FcepsilonRI expression on the surface of basophils, thus preventing IgG antibody-mediated crosslinking and the release of mast cell mediators. We analyzed activation and homing molecules of B cells and type 1 and type 2 cytokine production by T cells and document a new immunomodulator mechanism characterized by a reduction in B-cell activation and homing and in tumor necrosis factor-alpha and interleukin 4 production and an increase in interferon-gamma synthesis.
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Affiliation(s)
- E Iemoli
- Allergy and Clinical Immunology Unit, H. L. Sacco Milano, Italy.
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Borelli M, Lampati L, Vascotto E, Fumagalli R, Pesenti A. Hemodynamic and gas exchange response to inhaled nitric oxide and prone positioning in acute respiratory distress syndrome patients. Crit Care Med 2000; 28:2707-12. [PMID: 10966239 DOI: 10.1097/00003246-200008000-00004] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To analyze the single effect and the interaction of prone position and inhaled nitric oxide (iNO) on lung function and hemodynamic variables. DESIGN 2 x 2 factorial trial. SETTING Department of intensive care medicine at a university hospital. PATIENTS Fourteen patients on volume-controlled mechanical ventilation for acute respiratory distress syndrome (ARDS). INTERVENTION Four experimental conditions, each one characterized by the patient's position (supine or prone) with iNO or without iNO. MEASUREMENTS AND RESULTS Hemodynamic and gas exchange data were collected for each experimental condition. PaO2 was increased both by positioning (p < .01) and iNO (p < .01); iNO caused also a reduction in venous admixture (p < .01), pulmonary artery pressure (p < .01), and pulmonary vascular resistance index (p < .05). We could not demonstrate any significant interaction between the two treatments. The average effect of prone positioning was the same both with and without iNO, whereas the average effect of iNO was the same in both the prone and the supine position. CONCLUSION In the studied acute respiratory distress syndrome patients the average effects of iNO and positioning on oxygenation were additive and no interaction could be shown. A strategy including both treatments could warrant the best improvement in oxygenation, and should take into account the individual response to each treatment and the possible combination of the two.
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Affiliation(s)
- M Borelli
- Institute of Anaesthesiology and Intensive Care, University of Milan, Department of Anaesthesia and Intensive Care, S Gerardo Hospital, Monza, Italy
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12
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Huang Q, Shan S, Braun RD, Lanzen J, Anyrhambatla G, Kong G, Borelli M, Corry P, Dewhirst MW, Li CY. Noninvasive visualization of tumors in rodent dorsal skin window chambers. Nat Biotechnol 1999; 17:1033-5. [PMID: 10504711 DOI: 10.1038/13736] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Q Huang
- Department of radiation oncology, Duke University Medical Center, Durham, NC 27710, USA
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13
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Borelli M, Benini A, Denkewitz T, Acciaro C, Foti G, Pesenti A. Effects of continuous negative extrathoracic pressure versus positive end-expiratory pressure in acute lung injury patients. Crit Care Med 1998; 26:1025-31. [PMID: 9635650 DOI: 10.1097/00003246-199806000-00021] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To compare the effects of continuous negative extrathoracic pressure (CNEP) and positive end-expiratory pressure (PEEP) at the same level of transpulmonary pressure. DESIGN Prospective analysis. SETTING Medical intensive care unit of a university hospital. PATIENTS Nine consecutive acute lung injury patients. Patients with cardiac failure and patients with chronic lung disease were excluded from the investigation. INTERVENTIONS The patients were sedated and paralyzed while receiving mechanical ventilation and were studied in three different conditions: a) using a PEEP of 0 cm H2O (zero end-expiratory pressure); b) using a PEEP of 15 cm H2O; c) using CNEP. CNEP was applied to the thorax and the upper abdomen and its level was chosen to obtain a transpulmonary pressure similar to the one observed at a PEEP of 15 cm H2O. All patients had an arterial catheter, a pulmonary artery catheter, and a thermistor-tip fiberoptic catheter for thermo-dye-dilution in the femoral artery. These catheters were connected to an integrated monitoring system. We also placed an esophageal catheter in each patient to detect esophageal pressure. MEASUREMENTS AND MAIN RESULTS For each step, we assessed the hemodynamic variations by measuring intravascular pressures (via a pulmonary artery catheter), transmural pressures (computed by subtracting esophageal pressure from intravascular pressure), and blood volumes (derived from the technique of double indicator). The application of CNEP of -20+/-0.7 cm H2O produced a venous admixture and PaO2/FO2 improvement similar to that obtained with a PEEP of 15 cm H2O. This procedure is associated with a higher cardiac index (5.5+/-1.5 vs. 4.6+/-1.2 L/min/m2; p < .05) coupled with lower central venous pressure, pulmonary artery occlusion pressure, and higher transmural pressures and blood volume parameters. CONCLUSIONS In acute lung injury patients, a CNEP of -20 cm H2O has the capability to obtain transpulmonary pressure and lung function improvement similar to a PEEP of 15 cm H2O. CNEP differs from the positive pressure by increasing the venous return and the preload of the heart, and has no negative effects on cardiac performance.
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Affiliation(s)
- M Borelli
- Department of Anaesthesia and Intensive Care, Institute of Anaesthesiology and Intensive Care, University of Milan, S. Gerardo Hospital, Monza MI, Italy
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Gross RE, Burnett CB, Borelli M. Coping responses to the diagnosis of breast cancer in postmastectomy patients. Cancer Pract 1996; 4:204-11. [PMID: 8900762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE This study examined coping responses in women diagnosed with Stage I or Stage II breast cancer. METHODS A convenience sample of 36 patients with breast cancer was administered the Reaction to Diagnosis of Cancer Questionnaire (RDCQ) at 2 days and 30 days postmastectomy. RESULTS No statistically significant differences were observed in RDCQ scores between 2 days and 30 days postmastectomy (t = -1.57, P = 0.127). However, a significant change in the mean difference of the RDCQ scores was observed in women who had immediate breast reconstruction when compared to those women who did not have reconstruction (t = -2.34, P = 0.037). Additional results indicated that age and RDCQ scores had an inverse relationship, and women who were employed had significantly lower RDCQ scores at 30 days postmastectomy, indicating less positive coping. The variables of marital status, educational level, and number of days since diagnosis were not significant. CLINICAL IMPLICATIONS The results of this study may assist healthcare providers in understanding what affects coping in women diagnosed with early stage breast cancer.
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Borelli M, Fumagalli R, Bernasconi F, Cereda M, Gattinoni L, Pesenti A. Relief of hypoxemia contributes to a reduction in cardiac index related to the use of positive end-expiratory pressure. Intensive Care Med 1996; 22:382-6. [PMID: 8796387 DOI: 10.1007/bf01712152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE We have investigated the role that improvement in arterial oxygenation has, consequent on positive end-expiratory pressure (PEEP), in the reduction of cardiac index (CI) determined by applying PEEP. DESIGN 2 x 2 factorial trial. SETTING Department of intensive care medicine at a university hospital. PATIENTS 13 patients on mechanical ventilation for acute lung injury. INTERVENTIONS Four experimental conditions, each one characterized by one level of PEEP and one level of PaO2: LOLP = Low PaO2 (approximately 50 mmHg) Low PEEP (approximately 1 cmH2O) LOHP = Low PaO2 (approximately 50 mm Hg) High PEEP (approximately 10 cmH2O) HOLP = High PaO2 (approximately 80 mmHg) Low PEEP (approximately 1 cmH2O) HOHP = High PaO2 (approximately 80 mmHg) High PEEP (approximately 10 cmH2O) MEASUREMENTS AND RESULTS: Hemodynamic and gas exchange data were collected for each experimental condition. CI showed a 13% decline from LOLP (7.0 +/- 1.71/min per m2) to HOHP (6.1 +/- 1.31/min per m2). Both the direct effect of PEEP on the CI (LOLP + HOLP vs LOHP + HOHP, p < 0.01) and the indirect effect related to the improvement in oxygenation (LOLP + LOHP vs HOLP + HOHP, p < 0.01) contributed to the reduction in CI. CONCLUSIONS In evaluating CI changes induced by PEEP we should take into account the indirect effect of arterial oxygenation upon CI. This should be considered, at least in part, as a physiological adjustment rather than as impaired cardiovascular performance.
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Affiliation(s)
- M Borelli
- University of Milan, Department of Anaesthesia and Intensive Care, S. Gerardo Hospital, Monza (MI), Italy
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Borelli M, Avalli L, Foti G, Pesenti A. [The use of mixed venous saturation and percutaneous capillary saturation for determining the level of PEEP]. Minerva Anestesiol 1991; 57:119-21. [PMID: 1806818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- M Borelli
- Istituto Anestesia e Rianimazione, Univ. di Milano
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Foti G, Redaelli G, Lampati L, Makrì G, Borelli M, Avalli L. [Mixed venous oxygen saturation during continuous positive or negative pressure ventilation: a clinical case]. Minerva Anestesiol 1991; 57:123-5. [PMID: 1806819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- G Foti
- Istituto di Anestesia e Rianimazione, 1 Ospedale S. Gerardo Monza
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Borelli M, Cereda M, D'Andrea L, Bernasconi F, Travaini S, Pesenti A. [Role of changes in oxygenation in the reduction of cardiac output determined by the imposition of positive end-expiratory pressure]. Minerva Anestesiol 1991; 57:871. [PMID: 1961529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- M Borelli
- Istituto di Anestesia e Rianimazione, Università di Milano, Ospedale Nuovo S. Gerardo, Monza
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Rossi F, Kolobow T, Foti G, Borelli M, Mandava S. Long-term cardiopulmonary bypass by peripheral cannulation in a model of total heart failure. The decompression of the left heart through a percutaneous helical spring positioned within the lumen of the tricuspid and pulmonary artery valves. J Thorac Cardiovasc Surg 1990; 100:914-20. [PMID: 2246914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We performed long-term closed-chest cardiopulmonary bypass in an animal model of total heart failure (induced ventricular fibrillation). The extracorporeal system included a venous reservoir, a roller pump, a membrane lung, and a blood pulsator system. We cannulated the right external jugular vein for venous drainage and the right subclavian artery for arterial return. To decompress the left heart we passed by percutaneous cannulation a special helical spring mounted on a Swan-Ganz catheter (Baxter Edwards Divisions, Irvine, Calif.) and positioned it to rest within the pulmonary artery and tricuspid valves, which rendered them partly incompetent. After induced ventricular fibrillation, blood flow was raised to keep the central venous pressure at baseline values. The lungs were ventilated with 5% carbon dioxide in room air. During bypass, mean pulmonary artery pressure was 10.0 +/- 1.7 mm Hg, mean wedge pressure 11.9 +/- 1.8 mm Hg, and mean blood pressure 95.2 +/- 5.6 mm Hg. After 2 days (four animals) and 3 days (two animals) the hearts were defibrillated. There was immediate ejection from both sides of the heart. All sheep were weaned from bypass within 29 +/- 11 minutes and their lungs were ventilated with room air within 42 +/- 34 minutes. At autopsy hearts and lungs grossly appeared normal. We conclude that the percutaneous helical spring resting within right heart valves provided excellent decompression throughout the study, with full recovery of heart and lung function on defibrillation.
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Affiliation(s)
- F Rossi
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md. 20892
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Borelli M, Avalli L, D'Andrea L, Lampati L, Pesenti A, Gattinoni L. [Capillary oximetry as an index for determination of the level of positive end expiratory pressure (PEEP)]. Minerva Anestesiol 1990; 56:1239. [PMID: 2290550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- M Borelli
- Istituto di Anestesiologia e Rianimazione, Università degli Studi di Milano, Osp. S. Gerardo, Monza, Italy
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Borelli M, Kolobow T, Spatola R, Prato P, Tsuno K. Severe acute respiratory failure managed with continuous positive airway pressure and partial extracorporeal carbon dioxide removal by an artificial membrane lung. A controlled, randomized animal study. Am Rev Respir Dis 1988; 138:1480-7. [PMID: 3144216 DOI: 10.1164/ajrccm/138.6.1480] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Using an animal model of acute respiratory failure (ARF), we evaluated two treatments: conventional mechanical pulmonary ventilation (MV) and continuous positive airway pressure (CPAP) with extracorporeal removal of CO2 by an artificial membrane lung. We developed a model of "mild" ARF and a model of "severe" ARF after ventilating healthy sheep at a peak inspiratory pressure of 50 cm H2O for various lengths of time. Sheep from either injury models were randomly assigned to one of the above treatment groups. All 16 sheep from the model with "severe" ARF died, with progressive deterioration in pulmonary function and multiorgan failure irrespective of the treatment. Of 11 sheep from the model with "mild" ARF treated by MV, only three survived, whereas all 11 sheep from the model with "mild" ARF treated with CPAP and extracorporeal removal of CO2 responded well, and nine sheep ultimately recovered. We conclude that CPAP with extracorporeal removal of CO2 provided a better environment for the recovery in our model with "mild" ARF than the conventional arrangement centered on MV alone. Our studies also suggest that lung injury can progress (i.e., model with "severe" ARF) to where neither of the two treatments can succeed.
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Affiliation(s)
- M Borelli
- National Institutes of Health, Laboratory of Technical Development, Bethesda, Maryland 20892
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Kolobow T, Rossi F, Borelli M, Foti G. Long-term closed chest partial and total cardiopulmonary bypass by peripheral cannulation for severe right and/or left ventricular failure, including ventricular fibrillation. The use of a percutaneous spring in the pulmonary artery position to decompress the left heart. ASAIO Trans 1988; 34:485-9. [PMID: 3196550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The authors report that total cardiopulmonary bypass (CPBP) for severe heart failure can be safely maintained for several days through peripheral cannulation alone. In two healthy sheep under general anesthesia, the authors cannulated the right external jugular vein and the right subclavian artery. A special spring was attached to a 7F Swan-Ganz catheter and positioned at the level of the pulmonary artery (PA) valve, rendering it partially incompetent. The extracorporeal circuit included a venous reservoir, a roller pump, a membrane lung, and a blood pulsator set at 25 beats/min. Ventricular fibrillation was induced with 110 VAC. Extracorporeal blood flow was raised to 100-120 ml/kg min. Mechanical pulmonary ventilation was changed to 5% CO2 in room air. During bypass, the wedge pressure (WP) averaged 9-13 mmHg, PA pressure 7-13 mmHg, and central venous pressure 1-9 mmHg. After 38 and 48 hr respectively the hearts were defibrillated with DC shock. There was total heart failure with no ejection from right or left. We continued with TCPBP. The right heart recovered after 1 and 3 hr respectively. After 7 and 5 hr, respectively, there was some aortic ejection. By 11 and 4 hr, respectively, the sheep were off bypass and on room air, with return to baseline cardiac function. Throughout the recovery the WP averaged 4-8 mmHg. At autopsy, all hearts were soft and normal in appearance. Histologic examination of the lungs and the heart was unremarkable. The authors conclude that the PA spring readily decompressed the LV. Ventilating lungs with 5% CO2 in air during CPBP sustained excellent lung function.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- T Kolobow
- Laboratory of Technical Development, National Heart, Lung, and Blood Institute, Bethesda, Maryland 20892
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Kolobow T, Borelli M, Spatola R, Tsuno K, Prato P. Single catheter veno-venous membrane lung bypass in the treatment of experimental ARDS. ASAIO Trans 1988; 34:35-8. [PMID: 3288255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- T Kolobow
- National Institutes of Health, Laboratory of Technical Development, Bethesda, Maryland 20892
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Kolobow T, Borelli M, Spatola R, Tsuno K, Prato P. Single catheter venous-venous membrane lung bypass in the treatment of experimental ARDS. ASAIO Trans 1987; 33:561-4. [PMID: 3118921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- T Kolobow
- National Heart, Lung, and Blood Institute, Laboratory of Technical Development, Bethesda, MD 20892
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Kolobow T, Gattinoni L, Pesenti A, Solca M, Fumagalli R, Moretti M, Mascheroni D, Prato P, Borelli M. ECMO revisited. Int J Artif Organs 1987; 10:1-2. [PMID: 3553036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Pesenti A, Marcolin R, Prato P, Borelli M, Riboni A, Gattinoni L. Mean airway pressure vs. positive end-expiratory pressure during mechanical ventilation. Crit Care Med 1985; 13:34-7. [PMID: 3880689 DOI: 10.1097/00003246-198501000-00009] [Citation(s) in RCA: 82] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
To investigate the effects of both positive end-expiratory pressure (PEEP) and mean airway pressure (Paw) on gas exchange, we used lung lavage to induce severe respiratory insufficiency in six lambs. The animals were then mechanically ventilated at constant tidal volume, respiratory rate, and inspired O2 fraction. PEEP levels were varied -5, +5 and +10 cm H2O around the pressure (Pflex) corresponding to a major change in slope of the inspiratory limb of the respiratory volume-pressure curve. In each animal the effects of the three PEEP levels were studied at two Paw levels, differing by 5 cm H2O. Increasing Paw significantly improved PaO2 and reduced venous admixture. A 5-cm H2O PEEP increase from +5 to +10 did not affect oxygenation; however, oxygenation was significantly better when PEEP was greater than Pflex. Both PaCO2 and anatomic dead space were higher at higher PEEP, and decreased with increasing Paw. Hence, Paw was a major determinant of oxygenation, although a PEEP greater than Pflex appeared necessary to optimize oxygenation at a constant Paw.
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Abstract
A rare case of benign pelvic neurilemmoma with bladder infiltration and ureteral obstruction is presented. This neurally originated tumor may occur anywhere in the body, but involvement of the urinary tract is rare. Management depends upon location and other clinical findings, and in this case, since complete removal was impossible, urinary derivation was employed as a palliative treatment.
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Habr-Gama A, Borelli M, Alves PR, Bruschini H, Teixeira MG, D'Albuquerque LA. [Electric stimulation in the treatment of sphincter incontinence]. Rev Hosp Clin Fac Med Sao Paulo 1978; 33:177-8. [PMID: 725417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Habr-Gama A, Arruda Alves P, Borelli M, Haberkorn S, Brito Y, Gemeo Ferreira M, Albuquerque Cavalcanti C, Mello S. [Intra-anal electric stimulation in treatment of fecal incontinence]. AMB Rev Assoc Med Bras 1978; 24:112-4. [PMID: 308241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Borelli M. [Peculiarities of speech in different types of developing disharmony]. Rev Neuropsychiatr Infant 1968; 16:587-94. [PMID: 5688570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Chertok L, Donnet JL, Bonnaud M, Borelli M. [Semi-directive interview in a psychosomatic study in obstetrics]. Encephale 1966; 55:379-90. [PMID: 5971371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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